Many parents have been there: Your child comes home from school, camp or sports with head lice, and you panic. That was exactly what Plainview mother Michelle Geller did when the wingless, bloodsucking insects were found in her 10-year-old daughter Nicole's hair.

"I was hysterical. I started to rip my house apart. I threw out all the pillows, bedding, headbands, brushes and hundreds of dollars of American Girl dolls," says Geller, 39, a teacher who was also concerned that her two other young daughters, also with thick, long hair, could catch lice, too.

Geller had two choices -- get treatment or do it herself. But if she did it herself with over-the-counter remedies, she'd be right in the middle of a raging debate on the safety and effectiveness of home treatments.

STRONG CHEMICALS

The topical drugs used to treat lice are insecticides and can be dangerous if they are misused or overused, according to the federal Centers for Disease Control and Prevention. The agency encourages people to avoid overusing lice medication unless instructed by a pharmacist or physician. Other recommendations include not treating an infested person more than two to three times with the same medication and avoiding the use of multiple head lice drugs at the same time.

For Geller, treatment with some of the over-the-counter products was not an option. "I was not putting pesticides on my kid's head. These over-the-counter products have so many chemicals in them. I don't know what the risks or side effects of using them are," she says.

A friend told her about a local lice removal company that does not use harsh chemicals, LiceTamers Treatment Center, which makes house calls and also has a shop in Melville. The owner, nurse practitioner Melissa Levin, spent three hours going strand by strand through her daughter's hair while teaching Geller what to look for. "She taught me what was a nit and what a louse looks like," says Geller. (Nits are eggs and young lice and require magnification to see.) "I found it very educational."

NEW GUIDELINES

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Last month, the American Academy of Pediatrics issued new head lice treatment guidelines and highlighted increasing reports of resistance to some over-the-counter treatments. The recommendations include carefully following product label instructions and repeating treatment at the appropriate time to prevent reinfestation.

Elissa Rand, owner of Meticulice in East Setauket, says she has seen firsthand the increased drug-resistance of lice. "Lice has become resistant to these over-the-counter treatments because of over- and improper use," she says. "Most people panic and go out and buy Rid or Nix. They are not following instructions and applying the product daily when it should be done three different times throughout the month."

Dr. Cynthia Devore, lead author of the report and immediate past chairwoman of the council on school health for the American Academy of Pediatrics, acknowledged that parents need to be thoughtful when they do the treatment themselves but insisted that they not be alarmed.

"There are regional instances of resistance to some of the over-the-counter medications," says Devore. "The medications are regulated and have been in use and available for many years as a first treatment option, and if that is not working, we encourage parents to speak with their pediatrician."

Sklice Lotion, manufactured by the pharmaceutical company Sanofi Pasteur, is one of the newer prescription drugs. The 10-minute treatment is effective in just one application, according to the company, and does not require combing out nits from a child's hair.

For parents who don't want to use chemicals, but don't want to painstakingly comb the lice from a child's hair, there are professionals who will -- for a fee of $100 to $250 an hour.

Penny Good, owner of Port Washington-based LiceBeaters, says she has heard concerns about resistance to over-the-counter remedies. She says she swears by olive oil, a good lice comb and a little patience.

"There is no magic formula," explains Good. "We comb and inspect every strand. We use a 100-watt bulb that is directed onto the hair and wear magnifying glasses."

Some lice removal companies offer lice insurance, which covers treatment for up to one year or a lifetime prevention program that involves monthly head checks, while others sell their own pesticide-free products and DIY kits to remove the lice. They also offer head-check screenings, starting at $25. (If lice are detected, the fee is waived before the treatment begins.)

Geller, in fact, recently relived her family's drama. This month, her 5-year-old daughter also came down with head lice. This time Geller didn't get out of sorts. She had her own plan in place: "I ran to Melissa, and she treated my daughter and now all the lice is gone."

LICE AND SUMMER CAMP

Although many camps have their own head lice policies, it is important to be proactive, says Melissa Levin, a family nurse practitioner and owner of Melville-based LiceTamers Treatment Center. "Parents are starting to call me now to book their pre- and post-camp lice check appointments," which are $25 with a discounted rate for those who prepay, she says. "Most kids come straight from the camp. It's a madhouse."

Children staying in tight quarters at sleepaway camp should run a fine-toothed lice comb through the hair twice a week, she says. Applying some shampoos, conditioners, gels and sprays that contain tea tree oil, peppermint and rosemary may help keep lice at bay, she adds. Braiding long hair is also recommended.

Avoid sharing hairbrushes, combs and hats, and limit the number of selfies you take with friends. "Lice can easily be transferred from head-to-head contact," says Kathy Zappulla, owner of DeLiceful, a lice removal company with locations in Great Neck and Hauppauge. "All it takes is one person and it can just spread."

Tip for parents: "'Once a week, take a peek,' is my recommendation," says founder Elissa Rand. "It is better to check with a wet head than a dry head. During the shower, apply conditioner, then comb through the hair. Each time you comb out the hair, wipe the comb on a paper towel. If you have lice, you will see bugs."

For home use: Meticulice's Minty & Melly Elimination Kit, which includes a clip, a pair of magnifying glasses with lights, a lice comb and regular comb, $59.99. Available at Amazon, eBay and meticulice.com

Tips for parents: "There is nothing to be embarrassed about. If your child gets lice, contact the parents that your child has been in contact with in the last two weeks, otherwise the cycle will start all over again," says founder Kathy Zappulla.

Licebeaters: House calls only; this franchise has locations on Long Island and in New Jersey and Florida; 516-851-7412; licebeaters.com. Rates: $250 per hour (LiceBeaters charges by the hour and prorates the second hour. (There is no limit to the number of people who can get their heads checked for lice in the first-hour time slot.)

Tip for parents: "Lice removal is a process. There are a lot of combs, but not necessarily the comb you need. Our comb is stainless steel that has microgrooves, and that is what pulls out all the eggs," says co-founder Christine Bonanno.